Quitting smoking after diagnosed with lung cancer linked to nearly 30% improvement in survival

January 07, 2022

3 minutes to read

Source / Disclosures

Disclosures: The authors do not report any relevant financial disclosures.


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Quitting smoking at or around the time of diagnosis conferred a significant survival benefit in patients with lung cancer, according to the results of a meta-analysis published in Journal of Thoracic Oncology.

Attending physicians should educate these patients about the benefits of smoking cessation even after diagnosis and provide them with the necessary support, the researchers wrote.

Smoking cessation
Source: Adobe Stock.

“It’s really never too late to quit. Above all, it is a message for patients, as well as for doctors ”, Saverio Caini, MD, PhD, The senior medical epidemiologist at the Institute for Cancer Research, Prevention and Clinical Network (ISPRO) in Italy, told Healio. “Even if they are diagnosed with lung cancer, they can dramatically increase their chances of survival by quitting smoking as early as possible. In fact, we recommend that smoking cessation programs be fully integrated into multidisciplinary cancer care.

Justification, methodology

Caini and his colleagues have researched ways to increase the chances of survival of patients with lung cancer because, despite advances in immunotherapy, lung cancer is on average associated with a poorer prognosis than many. other cancers.

“Everyone knows that smoking is a risk factor for lung cancer, and many [patients with lung cancer] are diagnosed while still active smokers, ”Caini said. “Despite this, there was no certainty as to whether (and to what extent) quitting smoking after the diagnosis could improve survival.

The meta-analysis included 21 articles published between 1980 and October 2021 on the effect of smoking cessation at or around diagnosis in a total of 10,938 patients with lung cancer.

“We were surprised at the small number of studies that could be included, only 21, which is a tiny number compared to the number of studies that examine, for example, the association between smoking and risk [for] develop cancer, ”Caini said.

Caini and colleagues used random-effects meta-analysis models to aggregate study-specific data into a summary of relative risk. [SRR] and the corresponding confidence intervals.

Main conclusions

Results showed that patients who quit smoking after diagnosis had a 29% improvement in OS compared to patients who continued to smoke after diagnosis (SRR = 0.71; 95% CI: 0, 64-0.8).

Researchers found benefits of quitting regardless of histologic subtype, with SRRs for OS between smokers and continuous smokers of 0.77 (95% CI, 0.66-0.9) in patients with non-small cell lung cancer based on eight studies, 0.75 (95% CI, 0.57-0.99) in patients with small cell lung cancer on based on four studies, and 0.81 (95% CI, 0.68-0.96) in patients with lung cancer of both types or of unspecified histologic type based on six studies.

Caini and his colleagues were surprised at the magnitude of the effect.

Saverio Caini, MD, PhD

Saverio Caini

“A 20% to 30% reduction in the risk of death for those who quit after diagnosis to those who continue is enormous because it falls within the range of survival benefits that chemotherapy and immunotherapy bring to. [patients with cancer]Caini said. people with a disease as serious as lung cancer. ”

Implications

Based on the findings, oncologists and health systems should educate, encourage, and put in place systems to help patients quit smoking upon diagnosis, even with the challenges this poses for many patients.

“It’s hard because[lespatientsatteintsd’uncancerdupoumon}peuventêtredécouragésetdécouragésetsesentirtropdépriméspours’engagerdansl’arrêtdutabacd’autantplusqu’ilspeuventfumerdepuisdesdécenniescequirendl’arrêtencorepluscompliqué”adéclaréCaini”Lespatientsdoiventêtreconscientsquel’arrêtdutabacpeutêtrepresqueaussiefficace(pouraméliorerleschancesdesurvie)quelachimiothérapiel’immunothérapielaradiothérapieetcetqu’ilyabeaucoupdesoutienpoureuxs’ilsdécidentd’essayerd’arrêter”[patientswithlungcancer}maybedisheartenedanddiscouragedandfeeltoodepressedtoengagethemselvesinsmokingcessationespeciallyconsideringthattheymayhavebeensmokingfordecadeswhichmakesquittingevenmorecomplicated”Cainisaid“Patientsmustbemadeawarethatsmokingcessationcanbenearlyaseffective(forimprovingthechanceofsurviving)aschemotherapyimmunetherapyradiationtherapyetcandthatthereisplentyofsupportforthemiftheydecidetoattempttostop”[lespatientsatteintsd’uncancerdupoumon}peuventêtredécouragésetdécouragésetsesentirtropdépriméspours’engagerdansl’arrêtdutabacd’autantplusqu’ilspeuventfumerdepuisdesdécenniescequirendl’arrêtencorepluscompliqué”adéclaréCaini« Lespatientsdoiventêtreconscientsquel’arrêtdutabacpeutêtrepresqueaussiefficace(pouraméliorerleschancesdesurvie)quelachimiothérapiel’immunothérapielaradiothérapieetcetqu’ilyabeaucoupdesoutienpoureuxs’ilsdécidentd’essayerd’arrêter”[patientswithlungcancer}maybedisheartenedanddiscouragedandfeeltoodepressedtoengagethemselvesinsmokingcessationespeciallyconsideringthattheymayhavebeensmokingfordecadeswhichmakesquittingevenmorecomplicated”Cainisaid“Patientsmustbemadeawarethatsmokingcessationcanbenearlyaseffective(forimprovingthechanceofsurviving)aschemotherapyimmunetherapyradiationtherapyetcandthatthereisplentyofsupportforthemiftheydecidetoattempttostop”

For more information:

Saverio Caini, MD, PhD, can be contacted at the Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Cancer Risk Factors and Lifestyle Epidemiology Unit, Via Cosimo il Vecchio 2, 50141, Florence, Italy ; e-mail: [email protected]

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